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In Vitro Fertilisation and Systemic Lupus Erythematosus: Making The Correct Choice
Pankti U Tripathi1, Meenal M Patvekar1, Prashant Suryarao1
1Obstetrics and Gynaecology, Dr. DY Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus
|June 11, 2024
Summary
Systemic lupus erythematosus (SLE) in pregnancy requires careful management, especially after in vitro fertilization (IVF). Pre-conception evaluation and vigilant monitoring are crucial for preventing complications in women with SLE.
Area of Science:
- Rheumatology and Immunology
- Maternal-Fetal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune condition.
- Pregnancy in women with SLE carries increased risks for maternal and fetal complications.
- Hormonal changes during pregnancy, such as increased estrogen, can trigger SLE flares.
Observation:
- A 34-year-old woman with SLE, conceived via in vitro fertilization (IVF), experienced a lupus flare at 14 weeks of gestation.
- This case highlights the potential for SLE exacerbation during pregnancy, even with assisted reproductive technologies.
Findings:
- Pre-conception assessment of SLE disease activity, organ involvement, and hypercoagulability is vital.
- Screening for anti-phospholipid antibodies (APLA) is essential before assisted reproductive techniques (ART).
- Close monitoring and a multidisciplinary approach are necessary throughout pregnancy for SLE patients.
Implications:
- Optimizing pre-conception health and managing SLE proactively can improve pregnancy outcomes.
- Informed patient decision-making through clear risk-benefit counseling is paramount.
- Vigilant, multidisciplinary care is key to managing SLE during pregnancy and preventing adverse events.
